Reply to United Healthcare not covering certain ADHD meds

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[quote=Anonymous][quote=Anonymous]Did anyone else get a letter from UHC the other day indicating that they will not be covering certain ADHD medications after July 1? Both of the meds we use for our son are on the list -- Daytrana and Focalin. Basically they are saying that Metadate, generic Metadate, and Concerta work just as well, so you are supposed to switch. WTH! People spend months/years trying different meds and finally find one that works well with few side effects, and then this happens. I'm particularly concerned about Daytrana, which we switched to a few months ago with huge improvement over the Focalin (we still use Focalin on weekends sometimes and as a booster). The transdermal delivery system makes a huge difference in our case (lasts longer and is much smoother delivery), so saying that we should use a similar medicine that is capsule form seems ridiculous. The other advantage of the patch is that it can be removed whenever, which you can't do with a pill.

Has anyone ever tried to appeal these types of coverage decisions and had any success? I really hate to mess with our system that has been working so well.[/quote]

NO and please don't tell me this!!! We just started on Focalin after years of avoiding it because UHC wouldn't cover it. Now they cover it with a $50 co-pay so we started using it just a month ago and like it.  He was on Adderral for years.  Tried concerta, it was "eh".

Never tried Daytrana. Now I don't even want to consider it.

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